Losing and Fusing, Borderline Transitional Object and Self Relations – Roger Lewin, M.D. and Clarence Schulz, M.D., 1992

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Photo credit: RayMorris1 via Foter.com / CC BY-NC-ND

Jason Aronson Press

p. 10-13   “The Doctor – Patient relationship is the central integrative feature in an ongoing broadly conceived treatment of a borderline patient.  Everything else depends on it…. What do we mean when we talk of the doctor – patient relationship? … A relationship is not a thing.  Rather, it is a process of a high order of complexity, with many different aspects high-lighted differently at different times.  It changes.  It rearranges.  It can appear strikingly different at different times.  … When we talk of the doctor-patient relationship, we are talking of the “back and forth” between the doctor and the patient, which takes place along a variety of channels.  This “back and forth” has to do with words, looks, postural sets, and a whole series of cues that are interpreted, misinterpreted, and elaborated into fantasies, ideas, and actions by both parties.  It is visceral. …  It is the “back and forth” itself that is of the most fundamental importance and that serves to protect the flexibility and vitality of the treatment. … Relationship means repetitive meetings, separations, reunions.  It means repetitive risks, and hopes, repetitive disillusionments and despairs, repetititve repairs and doubts, but, above all, repetitions.  We intend the term repetition in the original etymological sense of trying over and over again.”

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